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Mental Illness

Mental illnesses are common in the United States. One in six U.S. adults lives with a mental illness (44.7 million in 2016). Mental illnesses include many different conditions that vary in degree of severity, ranging from mild to moderate to severe. Two broad categories can be used to describe these conditions: Any Mental Illness (AMI) and Serious Mental Illness (SMI). AMI encompasses all recognized mental illnesses. SMI is a smaller and more severe subset of AMI. Additional information on mental illnesses can be found on the NIMH Health Topics Pages.

Definitions

The data presented here are from the 2016 National Survey on Drug Use and Health (NSDUH) by the Substance Abuse and Mental Health Services Administration (SAMHSA). For inclusion in NSDUH prevalence estimates, mental illnesses include those that are diagnosable currently or within the past year; of sufficient duration to meet diagnostic criteria specified within the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV); and, exclude developmental and substance use disorders.

Any Mental Illness

Any mental illness (AMI) is defined as a mental, behavioral, or emotional disorder. AMI can vary in impact, ranging from no impairment to mild, moderate, and even severe impairment (e.g., individuals with serious mental illness as defined below).

Serious Mental Illness

Serious mental illness (SMI) is defined as a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The burden of mental illnesses is particularly concentrated among those who experience disability due to SMI.

Prevalence of Any Mental Illness (AMI)

Figure 1 shows the past year prevalence of AMI among U.S. adults.

In 2016, there were an estimated 44.7 million adults aged 18 or older in the United States with AMI. This number represented 18.3% of all U.S. adults.

The prevalence of AMI was higher among women (21.7%) than men (14.5%).

Young adults aged 18-25 years had the highest prevalence of AMI (22.1%) compared to adults aged 26-49 years (21.1%) and aged 50 and older (14.5%).

The prevalence of AMI was highest among the adults reporting two or more races (26.5%), followed by the American Indian/Alaska Native group (22.8%). The prevalence of AMI was lowest among the Asian group (12.1%).

Mental Health Treatment — AMI

Figure 2 presents data on mental health treatment received within the past year by U.S. adults aged 18 or older with any mental illness (AMI). NSDUH defines mental health treatment as having received inpatient treatment/counseling or outpatient treatment/counseling, or having used prescription medication for problems with emotions, nerves, or mental health.

In 2016, among the 44.7 million adults with AMI, 19.2 million (43.1%) received mental health treatment in the past year.

More women with AMI (48.8%) received mental health treatment than men with AMI (33.9%).

The percentage of young adults aged 18-25 years with AMI who received mental health treatment (35.1%) was lower than adults with AMI aged 26-49 years (43.1%) and aged 50 and older (46.8%).

Figure 2

Mental Health Treatment Received in Past Year Among U.S. Adults with Any Mental Illness (2016)

Demographic

Percent

Overall

43.1

Sex

Female

48.8

Male

33.9

Age

18-25

35.1

26-49

43.1

50+

46.8

Race/Ethnicity

Hispanic or Latino*

31.0

White

48.7

Black

29.3

Asian

21.6

2 or More

37.1

*All other groups are non-Hispanic or Latino

Prevalence of Serious Mental Illness (SMI)

Figure 3 shows the past year prevalence of SMI among U.S. adults.

In 2016, there were an estimated 10.4 million adults aged 18 or older in the United States with SMI. This number represented 4.2% of all U.S. adults.

The prevalence of SMI was higher among women (5.3%) than men (3.0%).

Young adults aged 18-25 years had the highest prevalence of SMI (5.9%) compared to adults aged 26-49 years (5.3%) and aged 50 and older (2.7%).

The prevalence of SMI was highest among the adults reporting two or more races (7.5%), followed by the American Indian/Alaska Native group (4.9%). The prevalence of SMI was lowest among the Asian group (1.6%).

Figure 3

Past Year Prevalence of Serious Mental Illness Among U.S. Adults (2016)

Mental Health Treatment — SMI

Figure 4 presents data on mental health treatment received within the past year by U.S. adults 18 or older with serious mental illness (SMI). The NSDUH defines mental health treatment as having received inpatient treatment/counseling or outpatient treatment/counseling or having used prescription medication for problems with emotions, nerves, or mental health.

In 2016, among the 10.4 million adults with SMI, 6.7 million (64.8%) received mental health treatment in the past year.

More women with SMI (68.8%) received mental health treatment than men with AMI (57.4%).

The percentage of young adults aged 18-25 years with AMI who received mental health treatment (51.5%) was lower than adults with AMI aged 26-49 years (66.1%) and aged 50 and older (71.5%).

Figure 4

Mental Health Treatment Received in Past Year Among U.S. Adults with Any Mental Illness (2016)

Demographic

Percent

Overall

64.8

Sex

Female

68.8

Male

57.4

Age

18-25

51.5

26-49

66.1

50+

71.5

Race/Ethnicity

Hispanic or Latino*

61.6

White

67.9

Black

56.8

*All other groups are non-Hispanic or Latino

Prevalence of Any Mental Disorder Among Adolescents

Based on diagnostic interview data from National Comorbidity Survey Adolescent Supplement (NCS-A), Figure 5 shows lifetime prevalence of any mental disorder among U.S. adolescents aged 13-18.1

An estimated 49.5% of adolescents had any mental disorder.

Of adolescents with any mental disorder, an estimated 22.2% had severe impairment. DSM-IV criteria were used to determine impairment.

Figure 5

Lifetime Prevalence of Any Mental Disorder Among Adolescents (2001-2004)

Statistical Methods and Measurement Caveats

National Survey on Drug Use and Health (NSDUH)

Diagnostic Assessment:

The NSDUH AMI and SMI estimates were generated from a prediction model created from clinical interview data collected on a subset of adult NSDUH respondents who completed a past 12-month version of the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (Research Version, Non-patient Edition (SCID-I/NP)).

People who only have disorders that are not included in these diagnostic modules may not be adequately detected. However, there are known patterns of high comorbidities among mental disorders; these patterns increase the likelihood that people who meet AMI and/or SMI criteria were detected by the study, as they may also have one or more of the disorders assessed in the SCID-I/NP.

Population:

The entirety of NSDUH respondents for the AMI and SMI estimates were the civilian, non-institutionalized population aged 18 years old or older residing within the United States.

The survey covered residents of households (persons living in houses/townhouses, apartments, condominiums; civilians living in housing on military bases, etc.) and persons in non-institutional group quarters (e.g., shelters, rooming/boarding houses, college dormitories, migratory workers' camps, and halfway houses).

The survey did not cover persons who, for the entire year, had no fixed address (e.g., homeless and/or transient persons not in shelters); were on active military duty; or who resided in institutional group quarters (e.g., correctional facilities, nursing homes, mental institutions, long-term hospitals).

Some people in these excluded categories had AMI and/or SMI, but were not accounted for in the NSDUH AMI and/or SMI estimates.

Survey Non-response:

In 2016, 31.6% of the selected NSDUH sample did not complete the interview.

Reasons for non-response to interviewing include: refusal to participate (22.2%); respondent unavailable or never at home (4.5%); and other reasons such as physical/mental incompetence or language barriers (4.6%).

People with mental illness may disproportionately fall into these non-response categories. While NSDUH weighting includes non-response adjustments to reduce bias, these adjustments may not fully account for differential non-response by mental illness status.

National Comorbidity Survey Adolescent Supplement (NCS-A)

Diagnostic Assessment and Population:

The NCS-A was carried out under a cooperative agreement sponsored by NIMH to meet a request from Congress to provide national data on the prevalence and correlates of mental disorders among U.S. youth. The NCS-A was a nationally representative, face-to-face survey of 10,123 adolescents aged 13 to 18 years in the continental United States. The survey was based on a dual-frame design that included 904 adolescent residents of the households that participated in the adult U.S. National Comorbidity Survey Replication and 9,244 adolescent students selected from a nationally representative sample of 320 schools. The survey was fielded between February 2001 and January 2004. DSM-IV mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview.

Survey Non-response:

The overall adolescent non-response rate was 24.4%. This is made up of non-response rates of 14.1% in the household sample, 18.2% in the un-blinded school sample, and 77.7% in the blinded school sample. Non-response was largely due to refusal (21.3%), which in the household and un-blinded school samples came largely from parents rather than adolescents (72.3% and 81.0%, respectively). The refusals in the blinded school sample, in comparison, came almost entirely (98.1%) from parents failing to return the signed consent postcard.